Classifying postherniorrhaphy pain syndromes following elective inguinal hernia repair

Background Chronic postherniorrhaphy pain is diverse in origin. The aim of our study was to classify postherniorrhaphy pain syndromes following elective inguinal hernia repair. Patients and methods All patients with an elective inguinal hernia repair performed between January 2000 and August 2005 received a questionnaire evaluating chronic inguinal pain (visual analog scale, VAS 0-10). Patients with moderate to severe pain complaints (VAS score >= 3) were invited for an interview and an outpatient department physical examination. Results A total of 2,164 cases underwent an elective hernia repair and received the questionnaire; 1,766 individuals responded (response rate: 81.6%). Moderate to severe pain was present in 211 patients (11.9%). Follow-up was performed in 148 patients. Three separate groups of diagnoses were identified. Group I: neuropathic pain (n = 72) indicating inguinal nerve damage; group II: non-neuropathic pain (n = 40) due to an array of diagnoses including periostitis (n = 18) and recurrent hernia (n = 13); and group III: a tender spermatic cord and/or a tight feeling in the lower abdomen (n = 43). Conclusions Chronic pain following elective hernia repair is common and diverse in etiology but may allow for a classification contributing to the development of tailored treatment regimens.